Abstract

EFFICACY OF CONTINUOUS WOUND CATHETERS DELIVERING LOCAL ANESTHETIC FOR POSTOPERATIVE ANALGESIA FOR SCOLIOSIS SURGERY. CASE REPORT

Micaela Barbosa L. Sales – MD, *Luiz Eduardo Imbelloni – MD, PhD, Bruno Brasileiro – MD, Julimar Nogueira – MD and Ronaldo de Lucena Farias – MD

ABSTRACT

Background: Scoliosis is an abnormal condition on the spinal curvature that affects 2-3% of the population and surgical treatment is associated with elevated levels of pain. The objective of this report is to describe the continuous wound infiltration system usage to manage postoperative scoliosis pain. Case Report: Female patient, 21 years old, 60 kg, ASA I, admitted for correcting thoracolumbar scoliosis, Cobb angle of 60 degrees. A total venous anesthesia with monitoring of sensory and motor evoked potentials for osteotomy in 10 levels (T5-L3) was performed. At the end of the procedure, two multiperforated catheters were implanted in the subfascial region by the surgeon. It was administered 10 mL of levobupivacaine 0.2% and the catheters were connected to an elastomeric pump containing 270 mL of levobupivacaine 0.2% with flow rate of 4 mL/hr. The quality of the analgesia was measured through the numerical verbal scale of pain (0-10), after 6 hours value 6, 12 hours value 4, 24 hours value 2, 48 hours value 0 and 72 hours value 0. There was no need for rescue with morphine. Both catheters were removed after 72 hours. Conclusion: An alternative technique to traditional methods of postoperative analgesia is the insertion of multiperforated catheters attached to the elastomeric pump, which allows the infusion of local anesthetic into the surgical wound, significantly reducing the pain and the use of morphine. The report suggests that this is a simple, well-tolerated technique, devoid of significant side effects and effective in the control of postoperative scoliosis pain.

Keywords: Acute pain; Local anesthetics; Infiltration anesthesia; Regional anesthesia.